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Ebola Outbreak in the DRC is Gaining Traction Following Rebel Violence

Map of the cases affecting the North Kivu region of the DRC. Photo: WHO

On August 1, 2018, the Democratic Republic of the Congo(DRC) announced that there is an outbreak of Ebola that is infecting the North Kivu province of the country. The new outbreak has documented 251 cases and 162 deaths. The number of cases is climbing every day, the week of Oct. 16-23 alone saw over 27 new confirmed cases. The outbreak plaguing the DRC, however, is not only of infectious diseases but also of widespread violence.

The North Kivu province as a whole borders Uganda and Rwanda. The region has seen great violence mainly caused by different rebel groups vying for power. The groups have been a constant threat in the region since the ethnic violence in the 1990s. More recently the fighting is mainly concentrated between the government forces and these rebel groups. However, these militias often launch surprise attacks on towns and aid groups. The Ebola crisis that is now taking hold of the region is one centered around and in part perpetuated by the widespread violence.

These militia groups operating in the region have targeted different NGO workers and health officials looking to stymie the outbreak. Many of the aid centers are attacked multiple times weekly often preventing the workers from doing anything. The attacks have also proven to be deadly as two health officials have been killed since August. As these assaults continue the crisis slowly gets worse as workers must cease giving out much-needed aid. During the attacks, workers have to stop giving out vaccines and may even lose track of patients. The World Health Organization(WHO) has categorized the status of the outbreak as “very high at the regional and national levels”. In their outbreak update published October 25 WHO stated that a major reason why the regional risk level is at “very high” is partly because the violence is “limiting the implementation of response activities”. The situation has escalated to the point that UN Secretary-General Antonio Guterres has called for a,” cease of attacks against civilians,” and is “outraged” about the actions that have taken place.

Health official being disinfected after working in one of the many aid centers.

A reason why the violence is so dangerous to outbreak response efforts is the distrust it is sewing among the population. In response to the rebel killings of 15 civilians protests broke out among civilians. The protests, however, reached a violent point as stones were thrown at trucks operated by local NGO groups. The growing trend is one of distrust toward the health workers attempting to respond to the outbreak. A distrust that has manifested in violence but also in actions that could drastically cause a worsening of the outbreak. Much of the distrust is centered around the need to do safe burials and how for families it can be a very jarring experience. This has caused new cases of the disease popping up from contact with bodies being exhumed. One particular incident included a group of over 20 men going to exhume a body of a safe burial after which they all became exposed to the disease. Luckily health officials pressed them to vaccinate, which they did.

Such instances of distrust combined with the increasing violence have caused a perfect storm for the outbreak to spread. Which is why unfortunately the outbreak seems to have no end in sight. Civil strife and infectious diseases do not cause for a good outcome, and that is being put on display in the DRC. This Ebola outbreak marks the country’s 10th in a 40-year span. Even if eventually this particular outbreak subsides if nothing changes the conditions are ripe for more to come.